Drug Guide
Methoxyflurane
Classification
Therapeutic: Anesthetic, Sedative
Pharmacological: Inhalational anesthetic agent
FDA Approved Indications
- Use as an inhalational anesthetic for induction and maintenance of anesthesia.
Mechanism of Action
Methoxyflurane produces anesthesia by enhancing the activity of GABA_A receptors in the central nervous system, leading to increased chloride conductance and neuronal hyperpolarization.
Dosage and Administration
Adult: Administer via inhalation using approved equipment; dose depends on procedure and patient response.
Pediatric: Use not approved officially; consult specialized guidelines.
Geriatric: Careful titration required due to increased sensitivity; monitor closely.
Renal Impairment: Use with caution; may accumulate and cause toxicity.
Hepatic Impairment: Use cautiously; liver function may influence metabolism.
Pharmacokinetics
Absorption: Readily absorbed via inhalation.
Distribution: Widely distributed throughout the body, crossing the blood-brain barrier.
Metabolism: Minimal metabolism; mainly exhaled unchanged.
Excretion: Primarily exhaled unchanged through the lungs.
Half Life: Approximately 2-3 minutes in healthy individuals.
Contraindications
- Known hypersensitivity to methoxyflurane or other halogenated anesthetics.
- History of malignant hyperthermia.
Precautions
- Use with caution in patients with renal or hepatic impairment, cardiac disease, or increased intracranial pressure.
Adverse Reactions - Common
- Dizziness (Frequent)
- Nausea (Frequent)
- Headache (Common)
- Fatigue (Common)
Adverse Reactions - Serious
- Malignant hyperthermia (Rare)
- Hepatotoxicity (Rare)
- Malignant hyperthermia (Rare)
- Cardiac arrhythmias (Rare)
Drug-Drug Interactions
- Concurrent use with other halogenated anesthetics or medications that sensitize the myocardium to arrhythmias.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor vital signs, oxygen saturation, and neurological status.
Diagnoses:
- Risk for impaired gas exchange.
- Risk for impaired neurological function.
Implementation: Administer under supervision in a facility equipped for anesthesia; monitor closely.
Evaluation: Ensure effective anesthesia with minimal adverse effects; monitor recovery and any adverse reactions.
Patient/Family Teaching
- Instruct about the purpose of the inhalation agent.
- Warn about possible dizziness, nausea, and coordination impairment.
- Advise to report any unusual symptoms immediately.
Special Considerations
Black Box Warnings:
- Potential for hepatotoxicity; use with caution, especially in long-term or repeated applications.
Genetic Factors: N/A
Lab Test Interference: May interfere with liver function tests if hepatotoxicity occurs.
Overdose Management
Signs/Symptoms: Hypotension, bradycardia, anesthesia overdose, hepatotoxicity.
Treatment: Discontinue administration immediately; supportive care; monitor vital signs; provide oxygen and ventilation support as needed.
Storage and Handling
Storage: Store in a cool, dry place away from heat and ignition sources.
Stability: Stable under recommended storage conditions.